Individual
KIM CELONE WILLMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-5500
Mailing address
221 LONGWOOD AVE # M80, BOSTON, MA 02115-5804
(617) 732-8060
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
9721
MA
103TH0100X
Health Service Psychologist
9721
MA
Other
Enumeration date
06/29/2011
Last updated
02/18/2020
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